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Medicare Part D Changes

Part D Standard Benefit Model Changes for 2015 detailedMedicare Part D Changes

The Part D Standard Benefit Model is a set of guidelines from the Centers for Medicare and Medicaid Services (CMS) that are applied to all Part D plans. The 2015 Medicare Part D changes are detailed below.

You will pay a higher deductible amount in 2015 (if required) and will spend more be in the donut hole if you are unfortunate enough to reach it.

A recent CMS news release indicates that Part D premiums will increase by an average of $1 in 2015. Part D premiums for 2015 plans will average about $32 per month.

Co-branding of plans with major retail chains and discounts for using preferred pharmacies will continue to be a popular trend.

Standard Benefit Model Costs for 2015 plans

  • The deductible will increase from $310 to $320 (not all plans require a deductible)
  • Initial coverage limit will be increased from $2850 to $2960
  • The out-of-pocket threshold will increase from $4550 in 2014 to $4700
  • Donut hole (coverage gap) begins when you reach the $2960 coverage limit and ends when you have spent $4700
  • Cost-sharing in the catastrophic portion will increase to the greater of 5% or $2.65 for generics and the greater of 5% or $6.60 for brand-name drugs

If you reach the donut hole you will receive a 55% discount on name brand drugs and pay a maximum of 65% on generic drugs.

You should look for your Annual Notice of Change and Evidence of Coverage document to detail any changes to your specific plan. This document must be mailed by September 30th.

5 things you should know about Medicare Part d before you enroll in a plan

 

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9 comments

  1. This is actually a question, I was just informed that Blue Medicare HMO i
    has been canceled and I will need to find a new program.I have looked at many Advantage plans with RX and seem to find WELLCARE of Florida to be very compatible with the Blue program. Have you heard of any problems with WELLCARE HMO and what is your opinion of this company?
    Any information you can give me will be greatly appreciated.

    Thank you,
    Tom Lane

  2. Tom, The Wellcare HMO is a popular Medicare Advantage Plan in Florida. I don’t recommend plans, but you can check the Medicare Star rating at medicare.gov or meet with an agent who represents the plan to ask any specific questions you may have. Comments I have received on my websites regarding Wellcare, (although based on an individual’s opinion) have been positive overall.

  3. I have Medicare disability, I also have coverage through my husbands employer as my primary. I can’t seem to find any answers as to how my Medicare may or may not change after Jan 1. I also have not received my annual booklet from Medicare, how do I get these answers and my booklet to view myself. I live in California. Have Part A and Part B Thank you.

  4. Shannon, If you have original Medicare (not a Medicare advantage Plan), there should not be any changes for you to worry about. You may want to speak with your husband’s HR department to learn more about how your coverage from his work work’s in conjunction with your Medicare.

  5. Thank you so much, sets my mind at ease.

  6. Hi. I’m on First Health Plan D. I received in the letter from them that my premium will be $17.90 per month for 2014. I live off on SSDI. I think $17.90 is alot. I am looking for lower than $17 dollars per month premium. I know you’re not allow to tell me which other Companies are better choice. For last 2 days I browse Part D plan of different companies and I haven’t seen which is better for me. I do wanted to drop First Health Part D on Jan 2014. I went to Social Security Admin. office and he said that I have to go to on website and I did. For last 2 days has been crazy. HELP. Thanks.Jim

  7. Jim, You are right, I can not tell you what would be the best Part D plan for your circumstances. But I can point you to the plan with the lowest premium.Humana Walmart Preferred RX has the lowest monthly premium at $12.60. Keep in mind that the lowest premium does not always equate to the lowest overall annual cost.

  8. My wife is 59 and has been on ssdi for 6 years . She has Medicare parts a and b . Even with my insurance thru my employer we still have copayments that range from $800.00 to $1000.00 a month. As other people have stated on your site the part d info in mind boggling . We live in Louisiana can you please give me a point in the right direction
    Thanks so much
    Kirk Badeau

  9. Kirk, I’m sorry it has taken me so long to respond. I endorse Ehealthinsurance as a good resource to compare all available plans with the help of a licensed agent. You can call them at (888) 310-0376. They have helped hundreds of my readers and subscribers.

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